{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T22:44:43Z","timestamp":1777848283531,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T00:00:00Z","timestamp":1491350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>Purpose: To evaluate the safety and effectiveness of antegrade vs crossover femoral artery access in the endovascular treatment of isolated below-the-knee (BTK) lesions in patients with critical limb ischemia (CLI). Methods: Between January 2014 and December 2015, 224 high-risk patients (mean age 75.8\u00b19.8 years; 151 men) with CLI underwent infragenicular interventions on 292 crural vessels in 3 European vascular centers. All patients had isolated TransAtlantic Inter-Society Consensus (TASC) C (n=26) or D (n=198) BTK lesions. Primary endpoints were freedom from access-related complications and technical success comparing the antegrade vs crossover access groups. Results: Balloon angioplasty was the most used treatment modality (169 vessels, 75.4%). The technical success rate was 88.4% in the entire cohort and 88.0% in the antegrade group vs 90.4% in the crossover group (p&gt;0.99). In all patients, the technical success rate was higher for stenotic lesions (100%) vs occlusions (85.5%, p=0.002) and in patients with TASC C BTK lesions (100%) vs TASC D (86.9%, p=0.033). The overall freedom from access-related complications was 97.8%: 99% in the antegrade group and 90.6% in the crossover group (p=0.022). Larger sheath size (5\/6-F vs 4-F) was associated with a significantly higher risk for access-related complications (7.1% vs 1.1%, respectively; p=0.047). Conclusion: The present multicenter study showed high technical success and a low incidence of access-related complications in the treatment of isolated BTK lesions using either antegrade or crossover femoral access. The antegrade approach with the use of a 4-F system seems to have a significantly lower rate of access-related complications.<\/jats:p>","DOI":"10.1177\/1526602817701251","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T06:19:25Z","timestamp":1491373165000},"page":"331-336","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Antegrade vs Crossover Femoral Artery Access in the Endovascular Treatment of Isolated Below-the-Knee Lesions in Patients With Critical Limb Ischemia"],"prefix":"10.1177","volume":"24","author":[{"given":"Yukun","family":"Li","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, St Franziskus Hospital M\u00fcnster, Germany"},{"name":"Clinic of Vascular and Endovascular Surgery, University of M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Esmail","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Sana Klinikum Hameln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos P.","family":"Donas","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St Franziskus Hospital M\u00fcnster, Germany"},{"name":"Clinic of Vascular and Endovascular Surgery, University of M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St Franziskus Hospital M\u00fcnster, Germany"},{"name":"Clinic of Vascular and Endovascular Surgery, University of M\u00fcnster, Germany"},{"name":"Division of Vascular Surgery, Aristotle University of Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Torsello","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St Franziskus Hospital M\u00fcnster, Germany"},{"name":"Clinic of Vascular and Endovascular Surgery, University of M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodosios","family":"Bisdas","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St Franziskus Hospital M\u00fcnster, Germany"},{"name":"Clinic of Vascular and Endovascular Surgery, University of M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Michelagnoli","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, 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